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Surgical Instrumentation : Use , C Are and Handling SURGICAL INSTRUMENTATION : USE , C ARE AND HANDLING 1958 1958 SURGICAL INSTRUMENTATION : U SE , C ARE AND HANDLING STUDY GUIDE Disclaimer AORN and its logo are registered trademarks of AORN, Inc. AORN does not endorse any commercial company’s products or services. Although all commercial products in this course are expected to conform to professional medical/nursing standards, inclusion in this course does not constitute a guarantee or endorsement by AORN of the quality or value of such products or of the claims made by the manufacturers. No responsibility is assumed by AORN, Inc, for any injury and/or damage to persons or property as a matter of product liability, negligence or otherwise, or from any use or operation of any standards, recommended practices, methods, products, instructions, or ideas contained in the material herein. Because of rapid advances in the health care sciences in particular, independent verification of diagnoses, medication dosages, and individualized care and treatment should be made. The material contained herein is not intended to be a substitute for the exercise of professional medical or nursing judgment. The content in this publication is provided on an “as is” basis. TO THE FULLEST EXTENT PERMITTED BY LAW, AORN, INC, DISCLAIMS ALL WARRANTIES, EITHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, NON-INFRINGEMENT OF THIRD PARTIES’ RIGHTS, AND FITNESS FOR A PARTICULAR PURPOSE. This publication may be photocopied for noncommercial purposes of scientific use or educational advancement. The following credit line must appear on the front page of the photocopied document: Reprinted with permission from The Association of periOperative Registered Nurses, Inc. Copyright 2012 “Surgical Instrumentation: Use, Care, and Handling.” All rights reserved by AORN, Inc. 2170 South Parker Road, Suite 400, Denver, CO 80231-5711 (800) 755-2676 www.aorn.org Video produced by Cine-Med, Inc. 127 Main Street North, Woodbury, CT 06798 Tel (203) 263-0006 Fax (203) 263-4839 www.cine-med.com 2 SURGICAL INSTRUMENTATION : U SE , C ARE AND HANDLING Surgical Instrumentation: Use, Care and Handling TABLE OF CONTENTS PURPOSE/GOAL /OBJECTIVES .....................................................................................................4 INTRODUCTION .............................................................................................................................5 MANUFACTURING PROCESSES .................................................................................................5 Stainless Steel ..........................................................................................................................5 Titanium ...................................................................................................................................5 Vitallium ..................................................................................................................................5 Other Metals ............................................................................................................................5 Instrument names .....................................................................................................................6 TYPES OF SURGICAL INSTRUMENTS .......................................................................................6 Cutting and Dissecting Instruments .........................................................................................6 Powered Cutting Instruments ..................................................................................................8 Clamping and occluding instruments ......................................................................................8 Grasping and Holding Instruments ........................................................................................10 Exposing and Retracting Instruments ....................................................................................10 Suturing and stapling instruments ..........................................................................................11 Accessory Instruments ...........................................................................................................12 ENDOSCOPIC (MINIMALLY INVASIVE) INSTRUMENTS .....................................................13 INSTRUMENT CARE AND HANDLING ON THE STERILE FIELD .......................................14 INSTRUMENT CARE AFTER PROCEDURE ..............................................................................15 Decontamination ....................................................................................................................15 Cleaning .................................................................................................................................15 Inspecting ...............................................................................................................................16 Endoscope Cleaning ..............................................................................................................16 Laparoscopic Instruments ......................................................................................................16 Powered Surgical Instruments ...............................................................................................18 SPECIAL PRECAUTIONS ............................................................................................................19 Ophthalmic Instruments ............................................................................................................ Prion Diseases ............................................................................................................................ PERSONAL PROTECTIVE EQUIPMENT (PPE) .........................................................................19 SUMMARY .....................................................................................................................................19 REFERENCES ...............................................................................................................................20 POST-TEST ....................................................................................................................................21 POST-TEST ANSWERS .................................................................................................................24 3 SURGICAL INSTRUMENTATION : U SE , C ARE AND HANDLING PURPOSE/GOAL The purpose of this study guide and accompanying video is to provide information to perioperative staff members on the use, care and handling of all surgical instruments including minimally invasive, powered and endoscopic instruments. OBJECTIVES After viewing the video and completing the study guide, the participant will be able to: 1) State the principles of instrument care. 2) Describe the four major categories of surgical instruments. 3) Name the basic components of powered instruments. 4) Discuss special considerations for endoscopic instruments. 5) Discuss intraoperative instrument handling including proper passing techniques. 6) Describe the proper cleaning required for each category of instrument. 4 SURGICAL INSTRUMENTATION : U SE , C ARE AND HANDLING INTRODUCTION instruments produced. It is important for perioperative staff Surgical instruments are members to know what each instrument is made of. The metal high quality tools that are alloys used in surgical instruments must be resistant to designed for accomplishing corrosion, which can result from exposure to blood, body a specific desired effect fluids, cleaning solutions, sterilization, and the atmosphere. during invasive procedures. Instruments are integral Stainless Steel components of all surgical Instruments made of stainless steel begin the manufacturing procedures. Perioperative staff members must understand the process with the conversion of raw steel into instrument use, handling, and care of surgical instruments. Proper blanks. There are more than 80 different types of stainless steel cleaning and handling minimizes damage, increases and these are graded based on quality and composition. The instrument life expectancy, and protects instruments, which most common grades used for surgical instruments are the 300 are a major financial investment for facilities. Careful and 400 series grades and of those, the 400 series is more planning, preparation, and use of instruments will contribute commonly used. Instruments such as retractors and speculums to an efficient and effective surgical procedure within a safe are generally manufactured from the 300 series, while cutting environment. and non-cutting instruments are made from the 400 series. Surgical instruments perform basic functions such as holding Titanium or retracting tissue; dissecting, cutting, or incising tissue; and Titanium has excellent metallurgical properties for use in assisting with suturing and or closure of the surgical incision. microsurgical instruments. The most notable and useful Most surgical instruments are made of stainless steel or other properties of titanium are that it is nonmagnetic and inert. It metals. The metal selected must be easily cleaned, disinfected, is harder, stronger, lighter in weight, and more resistant to and maintained. corrosion than stainless steel. 1 Surgical procedures are becoming more complicated and Vitallium intricate and as a result surgical instruments are becoming Vitallium, the trade name for a cobalt/chromium/molybdenum
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